The study attempts to review TQM models used in the health care sector and the obstacles to the application of TQM in the sector. Even though the TQM models in the manufacturing and service sectors were successfully applied, the applicability of TQM in the health care sector is still in question. The reason is the unique characteristics of the medical sector such as medical and management practices. The most of the TQM models in the health care sector come from manufacturing industries. The importance of the professional groups is, however, more emphasized in the sector than in manufacturing sector. The role of the groups are idiosyncratic to the sector. They generate some obstacles to the application of TQM in the sector. The barriers include cultural obstacles of health care organization. It naturally follows that the TQM in the health care sector requires the change of the organizational culture of the sector. The culture embraces the norms, rules, regulations, compensation system, morale, practices, and common experiences. To change the culture needs long term effort and modification of the rules, regulations, compensation system, and practices. It also requires staffs' training in the problem solving methods. The TQM in the health care sector needs that the interested parties should change. Since doctors group and nurses group are controlled in the bureaucratic and authoritative manner, they should learn the problem solving techniques which require the interaction with other groups. The management also needs to learn management skills and get thorough training on them.
Purpose: To identify factors that affect the job stress of visiting nurses at health centers in Seoul, Korea, who perform home care services. Methods: Data were collected in the period from November 20 to December 10, 2008, from 206 visiting nurses working at 25 health centers in Seoul metropolitan city. Self-report questionnaires of the Organization-Based Self-Esteem (OBSE) and the Korean Occupational Stress Scale (KOSS) were used. Data were analyzed by the SPSS win 15.0. Results: Several findings were obtained from the study. First, the mean of job stress was 52.4 points, which was higher than that of Korean women. Second, it was shown that by the sub-domain of job stress, the mean value belonged to the top 50% in the four sub-domains of physical environment, job demand, interpersonal conflict, and organizational system. Additionally, it belonged to the top 25% in the sub-domain of job insecurity, wherein the job stress was the highest. Third, the self-esteem of the nurses had the most significant effect on their job stress. Conclusion: Stress related to job insecurity was the highest among the visiting nurses at health centers in Seoul who perform the custom home care service thus, institutional support is urgently needed to alleviate such stress and secure their employment.
Purpose: To identify current status of university health care program. Methods: Data and information from homepages of 309 colleges or universities in South Korea were collected. The data was analyzed by frequencies, t-test, ${\chi}^2$ test with SPSS Ver. 18.0. Results: 117(37.9%) universities had organization of health care. Whether university had health care program or not had shown significantly depended on number of students, types of school (university or college), region, and existence of medical and nursing course. Medical course was shown as a strong predictor for facilitating university health care program limitedly focusing on diseases treatment. Health promotion programs have been operated in 15 universities, vaccination programs in 10 universities, and health screening in 20 universities. Conclusion: It is strongly recommended to revise the School Health Law for constructing a comprehensive university health care program consolidating health counseling and physical training.
This study investigated contents of mission statements for Strategic Management of hospitals in Korea and Japan. For the study, 44 tertiary care hospitals in korea, which were accredited by the Ministry of Health and Welfare, were selected. And 83 special functioning hospitals in Japan, which were approved by the Minister of Health, Labour and Welfare, were included. Both quantitative and qualitative analyses were conducted by classifying 5 components of the mission statement; market, service, philosophy, image, contribution. Findings from this study are as follow. First, hospitals in Korea emphasized image(93.2%) and philosophy(81.8%) components in their mission statements, whereas hospitals in Japan highlighted components of service(89.2%) and market(72.3%). In detail, mission statements of Korean tertiary care hospitals describe the components of hospital's image (93.2%), philosophy(81.8%), contribution(56.8%), market(22.7%) and service (18.2%) in order. On the other hand, mission statements of Japanese special functioning hospitals describe hospital's service(89.2%), market(72.3%), contribution(61.4%), image (49.4%) and philosophy(34.9%), respectively. Second, as results of Content analysis, there were some differences in mission statements of hospitals between two countries, and it is mainly from the divergences of standards for recognition of medical institutions, environmental factors, and different ways of mission statement description. For strategic hospital management, carrying out innovative restructuring organization or promoting of research and training for medical development is considered as a desirable approach. However, clear description of mission statement is more important and it is required for effective control and managing organization. And then the mission should be communicated within an organization so all internal members understand it and put their efforts to achieve the mission of organization. In conclusion, it is recommended that a leader and senior managers should re-evaluate its mission statement whether it reflects characteristics of an organization. In addition, a mission statement should be created or improved based on critical decision, as well as it should be clearly shared within an organization in order to become a future oriented organizations.
Since the establishment of health centers in the 1960s, the centers have been played an important role in providing basic health care for the people. Although the health centers made a great effect to prevent diseases and promote the health status of the people for the last three decades, the function of health centers should be strengthened to meet the health care need of individual, family and community. Over the last ten years, there have been great changes and developments in health related environments, such as population size and age, rapid urbanization, up-grading of the educational level, increase of income, health care demand for promotive health care measures and practical measures for chronic diseases and also practicing healthy life. According to the great changes in health related environments, the health centers should be reformed. The following policy options are recommended as a summary; First, the function of health centers should be converted from providing basic health services into promotive and preventive health care services, to meet changing needs of people. Second, the health center personnel should be reinforced for their competency to provide a qualitative services to people and also the operation of health center should be reactivated. Third, a close linkage of health centers with the private sector is an essential requirement for the operation of the health care delivery system within a health district in order to improve the health status of people. Fourth, type of manpower mix, scope of organization and health care program should be varied, based on the health care needs of people, geographical characteristics and size of population etc. Fifth, a comprehensive health care delivery system should be developed, for maintaining healthy life style of people and also the health and welfare services should be integrated in order n ensure an effective service.
Chunchoen Community Home Nursing Program (CCHNP) sponsored by Chuncheon City and Gangwondo Nurses Association was the first trial of community based home health nursing in Korea. The services have started since 1996. The purpose of the study was the evaluation CCHNP to establish standard of community based nursing program in Korea. The methods of evaluation were quantitative and Qualitative approaches. Evaluation for organization and management were conducted by the American Community Health Accreditation Program Standards With the result. several recommendations were suggested : It is necessary to expand the program to all the Gangwondo cities. And the liaison system is necessary between medical care facilities and community nursing home agency to establish the continuity of health care delivery system in home nursing program. Also it is necessary to set up the supporting system between community home nursing care agency and hospital home nursing department. Finally, the National Health Insurance should cover the cost of community home nursing care.
This study was conducted to describe trends of health services research (HSR) in Korea since 1968 and analyse the relevance of HSR to changes in health policy. Research methods are as follows: firstly, HSR articles were selected from 4 HSR related journals implicitly. Secondly, classification system of HSR was developed and then applied to previously selected papers in order to describe research trends. Finally, the frequency rankings of articles in research areas were compared with rankings in order of the importance of research area rated by experts. As a resesult, HSR articles have increased with time and three main research areas are health programme, health care financing, and health care organization/management. And many articles have been related to the efficiency and quality of health care since 1990. It seems HSR articles had little relevance to changes in health policy and policy environment. Especially, the recently disputed policy topic, namely the separation of prescription from disposing, has not received little attention since 1990. These findings suggest there is an urgent need for the reflection on HSR direction in Korea.
This study is planned to gather necessary data for setting up a system on students' health care in the university. In order to obtain statistical data on the students' health care problems especially in 'depression' among the mental health problems of the students, 'The Beck Depression Inventory' by A. T. Beck and 'Zung's Self-Rating Depression Scale' by W. W. K. Zung were used for gathering numerical data of scale of depression. It is evident that we have to prepare for further medical examination and health care educations for several students. For these students, it is clear that they have problems not only in mental health but also in physical health. I have screened out the high scored students for comparison and analysis. And it disclosed that we have to build up a periodical and continuous 'Health Screening System' utilizing Health Questionnaire for both physical and mental aspects, which will bring up us the very exact result to pick out any person who has healthy problem among the enormous number of the students with handy, convenient and effective procedures but with the least expense and effort. Also it is my firm confidence that this system will be applicable for primary health care control of mass population in local community or any organization.
The purpose of this study is to identify the status of school health and analyze affecting factors of school nurses' self confidence and nursing activities of the secondary school in Seoul. The data was collected from 13th of August to 30th of October. The self reported questionairs were distributed during one of the school nurses seminars held in Seoul and 93 secondary school nurses answered. Analysis of the data was done utilizing SPSS for percentage, mean, T-test ANOVA and Pearson Correlation Coefficients. The results of study are summerized as follows; 1. General Characteristics The mean age of the subjects was 33.4 and mean length of experience as a school nurse was 7.3 years. 79.5 percent of them had clinical experiences and the mean clinic experience was 2.1 years. The majority of them were graduate of the baccalaureate nursing programs and 82.8 percent of them were married. 72.0 percent of the sample had religion, and 60.2 percent of them were in the national or public schools. 90.3 percent of them had independent duty. 2. The status of school health resources In average, there were 2,445 students, 37 classes and 63 teachers per school nurse. 48.4 percent of them were aware of the school budget. The budget for school health was 585,000 won per school in average. 30.0 percent of the schools had school health organization. The schools whose health clinics were on the first floor consisted of 79.3 percent, among them 42.9 percent were on the center of the building office. 3. Activities of school health nursing The average number of students using health clinic were 430 per month. The majority of the problem was digestive problem. There were 7.5 times of mean correspondences with parents per year. The activities of the school nurses were clinic management (29.0%), health care services (23.5%) and health education (14.1%). 4. The degrees of self confidence of the school nurse and nursing activities Self confidence measured by 6 items of self-reported questionaires scored by 4 point Likert Scale revealed. The nurses' self-confidence was 2.922 in clinic management, 2.909 in health education, 2.759 in program planning and evaluation, 2.757 in health care services, 2.692 in management of school environment, and 2.250 in operation of school health organization. The nursing activities scored by 2 point. The nursing activities was 1,870 in program planning and evaluation, 1.853 in health education, 1.843 in clinic management, 1.739 in health care services, 1.696 in management of school environment and 1.265 in operating of school health organization. 5. Factors affecting self confidence and nursing activities of school nurses The general characteristics of the school nurses and the school health resources were related to self confidence and nursing activities. The most significant variable to nurses' self confidence was type of the school ownership and the presence of school health organization was the most significant factor to nursing activities.
Purpose: This study aimed to develop a client-centered integrated home nursing care model for rural areas by analyzing public health nursing, hospital-based home care services, and long-term nursing care in Korea. Methods: The literature review performed included data from the National Assembly Library, DBpia, RISS, and KISS, Google Scholar, the Ministry of Government Legislation, Statistics Korea, and the Ministry of Health and Welfare. Results: The client-centered and integrated home nursing care model in a rural area was opened as the Home Nursing Care Center in a public health center operating directly or on consignment. This model provides both a hospital-based home care services as well as long-term care, in accordance with the health status of the client and difficulty of nursing services. Moreover, the nurse who worked in a sub-organization (Centers for Supporting Healthy Living, Public Health Units, and etc.) of the public health center as care coordinator and case manager facilitates to connect home nursing care services and social welfare services. Conclusions: Our data indicates that the client-centered integrated home nursing care model in rural areas effectively combines professional services, regional accessibility, and social welfare services.
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